Jessula Samuel, Herman Christine R, Lee Min, Lightfoot Christopher B, Casey Patrick
Department of General Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.
Division of Vascular Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.
J Vasc Surg Cases Innov Tech. 2017 Sep 19;3(3):163-166. doi: 10.1016/j.jvscit.2017.04.001. eCollection 2017 Sep.
We report renal salvage maneuvers after accidental bilateral renal artery coverage during endovascular aneurysm repair of an infrarenal abdominal aortic aneurysm. A 79-year-old man with an infrarenal abdominal aortic aneurysm was treated with endovascular aneurysm repair. Completion angiography demonstrated coverage of the renal arteries. Several revascularization techniques were attempted, including endograft repositioning and endovascular stenting through the femoral and brachial approach. The patient eventually underwent open splenorenal bypass with a Y Gore-Tex graft (W. L. Gore & Associates, Flagstaff, Ariz). After 3 months, computed tomography showed no evidence of endoleak and patent renal arteries. Renal function was well maintained, and the patient did not require dialysis.
我们报告了在肾下腹主动脉瘤血管内修复术中意外双侧肾动脉被覆盖后的肾脏挽救策略。一名患有肾下腹主动脉瘤的79岁男性接受了血管内动脉瘤修复治疗。完成血管造影显示肾动脉被覆盖。尝试了多种血管重建技术，包括移植物重新定位以及通过股动脉和肱动脉途径进行血管内支架置入。该患者最终接受了使用Y型戈尔泰克斯移植物（W.L.戈尔公司，亚利桑那州弗拉格斯塔夫）的开放脾肾旁路手术。3个月后，计算机断层扫描显示无内漏迹象且肾动脉通畅。肾功能得到良好维持，患者无需透析。
